05 December 2006 3:28 PM

How long can we afford to plunder the world for our doctors?

Read Peter Hitchens only in The Mail on Sunday

At the weekend I learned that an old acquaintance had suffered a severe heart attack. It was a harrowing and shocking experience. I am happy to say that he was treated so quickly and competently by the NHS that he has suffered no long-term damage.

One of the things he noticed was that the doctors, nurses and technicians who looked after him so well were, as he put it a 'United Nations', from countries all over the world. Surprisingly few had English as a first language. This was in London, which ceased some time ago to be an English city, but I suspect it's also true in many other parts of the NHS.

The argument here isn't about the competence or quality of these hard-working professionals. As my acquaintance found, they were more than equal to the tough task of saving his life and restoring him to health.

It's this. Do we have the right to strip countries less wealthy than our own of their expensively-trained doctors, nurses, radiographers etc, just because we are currently more wealthy than they are? What is wrong with our own education system that we need to do so? And, perhaps most worrying of all, there is this : what will happen when we cease to be so rich, and cannot afford to import the skills we need? Will our own best doctors vanish to work in India or China, while we are left with understaffed hospitals and second-rate care?

I think we are currently living in the afterglow of past economic success. I cannot see any real reason why this country is rich, why the pound sterling is such a valuable currency. What do we make that the world wants to buy? What are we good at, that we can sell abroad or even at home? Our boom is based, it seems, on property bought on loans, and then used to raise more loans, and on mass immigration keeping down the wages of the service sector.

Economists keep telling me that all is well, that we provide 'services' to the world, that manufacturing industry is not important, that poor countries can produce steel and other strategic goods. But what are these 'services' and who is providing them? Can they really sustain, in affluence, a population this big? Brought up as I was in the days when we all thought everything British was the best in the world, I've been cruelly disillusioned by travelling abroad and finding that this simply isn't so. In many economic areas, British goods don't even exist any more.

Meanwhile our dreadful state schools leave millions ill-equipped to face the astute, literate, disciplined hardworking competition of Eastern Europeans and others, and our welfare system discourages work. I do not think this can go on much longer. But is the 'Centre Ground' worried? I don't get any sense that it is.

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Comments

The reason for this can be summed up by the fact that as a nation we are now suffering from what the journalist Ian Glass described as Institutional Incompetence. There are many reasons for this, but a principle one must be the decline of the educational system since the system. A prime example is that my old Alma Mater Exeter University has closed its Chemistry Department for lack of applicants, so that we are no longer producing graduates in subjects such as science and engineering which we need to have a thriving economy, while at the same time young people want to do subjects such as media studies. This will only be made worse if the government's stupid idea to make everyone stay at school until they are 18. This means that we are producing young people who can only be employed in non-productive publicly subsidised jobs, while we have to import people to jobs that actually require hard skills, whether it be surgeons, plumbers, or footballers, from overseas.

Why don't we stop beating around the bush! The fact is, the UK is still seen by foreigners as a country of standards and etiquette. You only have to look at the buses of Poland or any other East / South East European country, and realise that this country has a lot going for it. Directly opposing this is the fact that the indigenous population of this country are too fat and lazy to do any jobs, or come to that, even try and study - that's why our doctors are now coming in from Iran, Iraq, Jordan, Pakistan, India etc - where these people appreciate the value of sterling, as compared to ours.
Rap music, wearing 'hoodies' is the name of the game with most of the new underclass. The educated foreigners are going to help us maintain the UK standards - this is for the time being.
The government, whether Labour or Conservatives, are perpuating the myth that everything's fine here, and yet by creating this underclass, it furthers their motives in filling their pockets with wealth.

Peter,
We trained some of the best doctors in the world, but lost them to other countries. Have you ever heard of the 'brain drain'?

We lost them because of the money we were paying them, and the working hours imposed on them. Now that it is happening in reverse, people are up in arms.

In the same vein, one of my duties as a Magistrates' Court Clerk in the '80's was to take potential emigrants before a magistrate to get copies of their qualifications certified as true. About 80 per cent of these applicants were nurses, intending to go to Australia, New Zealand, Canada and America.

In those days, the UK was paying to train them, but not paying to keep them, so they were going abroad.

Dave Murphy's comments reminded me of a Womens' Hour programme I heard more than 3 years ago. They were discussing the fact that there were many more girls than boys studying to become doctors, dentists and vets, partly due to positive discrimination. Being the feminist programme it is you might have expected to hear them saying what a great thing this was for women and the country. But they weren't. They were discussing the crisis which they could foresee starting in 5 - 6 years ahead when many of these girls started to have children, which is a natural desire of most females.

There are more female than male doctors in our local medical practice, but one was absent recently to have a baby, and another only works part time to be able to look after her family. So the shortfall in doctors due to misguided policies has to be made up somehow, and we then bribe doctors trained in poorer countries, where they are badly needed, to come here to fill our shortages. And the adoption of EU inflexible working hours is going to make the situation worse. Our ethical politicians don't seem to have any shame for letting this situation happen.

All these doctors and nurses from overseas. Is this not pay back time? For three hundred years we sent many of our brightest and best to the four corners of the world.It seems resonable for the brain drain to work in reverse for a while,I doubt that it will last three hundred years.

One of the problems is that the feminists worked so hard to get 'womens equality' in education.
What the system we have now (idealistically) forgets is that the vast majority of women are constrained by their biology and reach a point whereby they stop working to raise children. This leaves huge gaps in services - which can only be supported by importing workers (as we cannot afford to educate the same people twice or twice as many people). What we actually need to do is ensure that we get more men training in our universities and hospitals - who will not give up the role for 10 years (and return part time).
This is not sexism - it is realism - the inability of our feminist leaders to accept it will condone much of the third world to poor healthcare - many of them females. As our ancestors realised thousands of years ago - women are constrained - not by male oppression - but their own biology, choices and needs. We as a nation - have to recognise this to reverse the crisis which threatens to overwhelm this country - and the world.

One of the main reasons that medical staff move to Europe/Britain is that the conditions in their own countries are terrible. Take South Africa where in the last 12 years, hospitals have deteriorated abysmally and if you are White, you stand no chance of getting a job anyway, despite the shortages as the Law forbids it now. When you do, the pay is very low and it is often a dangerous environment, especially in A & E. The benefit, of course, is that those who do and return, gain First World experience to the benefit of their home country.

When the NHS was formed, the Government could and should have built more medical schools to train adequate numbers of doctors. There were certainly enough interested and qualified school leavers to study medicine.

However the Goverment realised that by importing foreign trained doctors, they could simultaneously reduce their expenditure on higher education and reduce the salaries of NHS staff. Foreign staff have less bargaining power than home trained ones. Both factors have lead to the NHS becoming a less attractive employer and hence career for the native population.

Further to my comments on the “short termism” of our society. Maybe as fewer of us have children and even fewer grandchildren we could ask why should we care that the ice caps will have melted by the time they would have reached middle age? Or that the EU will resemble a gigantic Old Peoples’ Home, by then, and be staffed by third world immigrants?

Planning for future generations makes more sense when you have an interest in the form of descendants, as our old landed families demonstrated.

We have newly qualified Doctors, nurses, radiographers, midwives etc in this country
who can't find a job because of the recruitment freeze. Some are working in supermarkets and bars etc. they are the lucky ones who can at least earn some money. Students who have never paid stamp can't claim job seekers allowance and they haven't had any money since they qualified.

My daughter qualified in diagnostic radiography and imaging this summer, she has not had any money since July because she can't find any paid work. The last radiography post she applied for atracted 80+ applicants. Soon, more graduates will be
out there looking for work and the deficit in the NHS will still be there.

Graduates from our country haven't got the option of working in another country because they need two years working experience to do so and they can't do that due to the recruitment freeze.

Glad to see you raising this issue, I have long considered it an obscenity that we, the fourth richest nation on Earth, are using some of the poorest nations to train our medical staff more or less free of charge.

I have come to the conclusion that 'Economics' has no basis in reality and is little more than an absurd form of mathamatics that would not be out of place in the world of Lewis Carroll. Most of the money in circulation in Britain is based on credit. A person might as well use Monopoly money for their transactions.

I agree with every word of that, Mr Hitchens. Our Chancellor found out long ago that mass immigration was helping to boost the housing market and that's one of the main reasons why it's been allowed to carry on.

The property boom is protecting this Government from the public anger it deserves and a slump can't come too soon. Until that happens the country will have no motivation to heal itself.

The reason so much of British industry is in the hands of foreigners is that we are selling off our assets to maintain our standard of living. This is also happening in the USA. The root cause is the massive balance of payments deficit caused by the UK and US neglecting manufacturing industry. So far this economic disaster has been hidden by both governments printing trillions of extra banknotes. Unfortunately, this can't go on forever and a reckoning awaits just around the corner.

The problem surely goes deeper than plundering the poorer parts of the world for skilled staff; it is the short term planning frame our “leaders” have.

I suppose in demographic terms Europe has no long-term future. Taking Germany as an example by 2050 their population will have fallen by 23 million and a third of them will be over 65, outnumbering the young by two to one. And still they pretend pensions will be paid at their present level!

What world do European leaders live in where poor third world immigrants will be prepared to pay high taxes to keep old rich Europeans?

Like an animal that has not evolved to suit a changing environment we have created a social system that is doomed to fail.

You ask why we don’t invest in real education and produce the skilled workforce we need? Because our political class seems to have a planning horizon that barely extends a decade let alone a generation or more as our past much derided ‘establishment’ did.

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